The purpose of this study was to determine the prognosis of children and adults in whom decompressive craniectomy (DC) was used as a rescue treatment to lower refractory high intracranial pressures if maximal conservative therapies failed.Data of DC patients were retrospectively reviewed. Three-month and 1-year outcomes were evaluated (modified Rankin Score). Twenty-one patients were studied, 8 children and 13 adults. Eleven suffered from traumatic brain swelling, in 10 the primary pathological condition was intracranial hemorrhage, arteriovenous malformation bleeding or subarachnoid hemorrhage. All 13 survivors (62%) had a favorable outcome after 1 year (mRS≤3), 8 (38%) lacked any disabilities at all. Therefore, decompressive craniectomy offers a chance for a favorable outcome in uncontrollable ICP.